The effects of codeine for children
¿Codeine when children have a cough? Not so fast. The American Academy of Pediatrics (AAP, for its acronym in English) has warned that codeine is not a safe drug to relieve pain or cough in pediatric patients.
As explained by American pediatricians, the drug is associated with the appearance of serious or fatal respiratory complications in children. "We are convinced that there's never any reason to use codeine"says Joseph Tobias, an expert at Ohio State University and the National Children's Hospital of Columbus, Ohio, to Scientific American.
This pediatrician has carried out an investigation, published in the journal Pediatrics, in which he reviews the potential adverse effects in children treated with codeine. In this study, they were able to identify 64 cases of low respiratory frequency and 24 cases of drug-associated deaths, of which 21 were under 12 years old.
Side effects in children
According to the researchers, these serious consequences occurred in patients treated with a combination with acetaminophen after a surgery In addition, there were some nocturnal respiratory disorders that had also been linked to codeine, a risk that increases if the child is overweight.
The recommendation of pediatricians is not only because of the risks of codeine, but because does not exist "sufficient evidence that the drug works in the pediatric population," explains the academy. "There is little evidence that it alleviates childhood cough and there are more and more studies that suggest an absence of response in the treatment of pain," they warn.
The choice of Spanish pediatricians
In our country, codeine is restricted to children under 12 years of age. This 'prohibition' exists since 2013, when the Committee for the Evaluation of Risks in European pharmacovigilance (PRAC) put the eye on medicines that contained codeine and that were indicated for the treatment of children's pain.
After this review, the PRAC initiated a new evaluation, considering that the detected risks could be extrapolated to the codeine that is used for cough in children. These are the recommendations to which he took.
When not to use codeine
- In under 12 years old old.
- In those patients known to be ultrafast metabolizers, because they have a high risk of morphine poisoning.
- In women during breastfeeding, due to the risk that the child would suffer from serious adverse reactions in case the mother was ultra-rapid metabolizer.
- It is not advisable to use codeine in patients between 12 and 18 years of age who present compromise of respiratory function due, for example, to neuromuscular disorders, severe respiratory or cardiac pathology, pulmonary infections, multiple trauma or patients who have undergone extensive surgical procedures.
Damián Montero:
